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Stroke Smart Magazine

May/June 2007
Q & A

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Show Me the Money

By Brent Neiser, National Endowment for Financial Education

SS: Why is it important for stroke survivors to seek financial advice?

For many people, a stroke is an economic event, like a job loss. After a stroke, you may not be able to work for awhile, reducing your household income. At the same time, you may experience a dramatic increase in expenses, such as costly rehab treatments or having to make your home wheelchair accessible. So it's important to have a financial strategy when dealing with the effects of stroke.

SS: Where do you start?

If you are employed, then start by communicating with your employer. Be sure to get a clear sense of employee benefits regarding sick time, short- and long-term disability, and health insurance. This will help you determine how much financial help you can expect to receive. You may also want to discuss your options in terms of a flexible work schedule, job sharing and whether or not you would be allowed to work from home. Know your options. If you are retired, you may be receiving some sort of income already and just need to figure out what your health insurance will and will not cover.

Also, you'll want to look at your financial life, your liabilities, your cash flow and your expenses. This can be overwhelming for some families, especially if they are not used to thinking or talking about these things. If necessary, seek help from a trusted advisor or accountant to come up with your financial strategies.

SS: How do you choose a financial strategy?
Once you get a better idea about your situation, then it's time to decide what to do about it. That could mean cutting back, increasing cash flow, reducing your liabilities, getting help from others, and uncovering hidden resources.

SS: What are some ways for people to cut back?
There are many ways to cut back. You can delay or scale back on vacations and large purchases, rent or borrow tools and equipment instead of buying them, buy generic items instead of your favorite brands, and use coupons to save money on essentials such as groceries.

SS: How do you increase cash flow?
People think that they have to get an actual job with a paycheck to increase cash flow, but that's not the case. Increasing cash flow is a matter of freeing up some money to support your needs. For example, maybe you own something you don't need anymore, like an extra car. Even if you're not making payments on it, you are paying insurance and property taxes on that car. If you can unload that extra car, you'll be freeing up money to use on something else. Be creative! Consider selling a few things you don't need anymore.

SS: What does it mean to reduce your liabilities?
Basically, liabilities are financial obligations arising from past transactions or events, such as credit card debt or money owed for the purchase of a home. You don't want to cut your lines of credit because you may need to use them. But you do want to be very careful about the use and management of your lines of credit. Avoid taking on new liabilities that aren't necessary. Also, you may want to reduce the temptation to buy new things by leaving some of your credit cards at home when you are out and about.

SS: What kind of help can you get from others?
It may be time to call in some favors from friends and family, take advantage of community groups and churches, or shift the burden to another family member. If you can't drive yourself to your appointments, ask people to give you rides instead of paying for taxis or public transportation. Get people to help you out in the house instead of paying for services such as house cleaning and caregiving. If you were the breadwinner of your household and now you can't work, then someone else in the house who isn't currently working or who is working part-time may need to step up.

SS: How do you uncover hidden resources?
There are many types of hidden resources available, you just need to figure out how to access them.

One type is related to drugs and medical bills. What many people don't know is that some prescription medicines are available free-of-charge or at discounted rates from the companies that make them. To see if you qualify, call the pharmaceutical company that makes your drug and ask about special programs to help you. If you don't know which company makes the drug(s) you take, ask your pharmacy. Also, some healthcare providers may be willing to negotiate fees or work out a payment plan. Ask your doctor, dentist, hospital or pharmacy for a lower price.

You also may be able to get your health insurance company to pay for things for which they originally deny payment. If your insurance plan denies your claim for a treatment or medicine, you have a right to appeal. Every health insurance plan has different rules and procedures, so be sure to contact yours to find out how to file an appeal. If you have a Medicare Prescription Drug Plan, the plan will send you materials about complaint and appeal procedures. Don't be afraid to ask your doctor's office to help you file an appeal, or at least to give you a written explanation of the problem that you can include in your appeal letter.

When doing your taxes, check to see if you can deduct your medical bills.

SS: What other resources are there?
Assets, such as your home, may be a good resource for you.

If you own your home and are over the age of 62, you may want to consider a reverse mortgage. This is a popular way for older homeowners to convert part of the equity in their homes into tax-free income without having to sell the home, give up title, or take on a new monthly mortgage payment. In a reverse mortgage, the payment stream is “reversed.” Instead of making monthly payments to a lender, as with a regular mortgage, a lender makes payments to you. You can choose to receive the money from a reverse mortgage all at once as a lump sum, fixed monthly payments either for a set term or for as long as you live in the home, as a line of credit, or a combination of these. The most popular option — chosen by more than 60 percent of borrowers — is the line of credit, which allows you to draw on the loan proceeds at any time.

Additional Resources
Ask your hospital social worker to recommend financial advisors or credit counselors that work with people who have long-term disabilities or illnesses. Ask the social worker which financial strategies have been successful for others in your position.

The Financial Planning Association® connects those who need financial help with those who provide it. To search for a certified financial planner in your area, or to find out more about how a financial planner could help you, go to .

To learn more about patient assistance programs offered by pharmaceutical companies, call The Partnership for Prescription Assistance toll-free, 1-888-4PPA-NOW (1-888-477-2669).

You can also call the U.S. House of Representatives' Special Committee on Aging at (202) 224-5364 and ask for the free Information Paper on Programs to Help Older Americans Obtain Their Medications. This report describes the programs of drug manufacturers that have a special program of this kind. Read it carefully and then talk to your doctor if you think you may be eligible.


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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